Provider Demographics
NPI:1205383494
Name:JOHNS, ROBERT (LPC, CACIII)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:JOHNS
Suffix:
Gender:M
Credentials:LPC, CACIII
Other - Prefix:
Other - First Name:CHARLIE
Other - Middle Name:
Other - Last Name:JOHNS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, CACIII
Mailing Address - Street 1:2560 W 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3712
Mailing Address - Country:US
Mailing Address - Phone:303-477-8280
Mailing Address - Fax:303-477-1369
Practice Address - Street 1:2560 W 29TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3712
Practice Address - Country:US
Practice Address - Phone:303-477-8280
Practice Address - Fax:303-477-1369
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1348101YA0400X
CO3108101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)